Substance Dependence

Criteria

3 or more following Sxs occurring in same 12 mo. period:

i) tolerance

ii) withdrawal

iii) increasingly larger amounts taken

iv) can't stop

v) takes up time

vi) important parts of life given up

vii) substance continued despite knowledge of addition

Substance Dependence

Specifiers

Specifiers:

I) With physiological dependence

   (signs of tolerance or withdrawal)

2) Without physiological dependence

    (no evidence of tolerance or withdrawal)

Substance Dependence

Course Specifiers

*Only when 1 month with no Sxs present and not in a controlled environment.

I) Early full remission - [Full - so Sxs of abuse or dependence] + [Early - 1-2 months]

II) Early partial remission [@ least 1 Sx of abuse or     dependence present]

III) Sustained partial remission - sustained [12+ months]

IV) Sustained full remission

V) On Agonist therapy

VI) In a controlled environment

Substance Abuse

Criteria

Must have 1+ months Sxs over 12 month period

I) Use that interferes with life responsibilities

II) Use in situations where hazardous

III) Use that causes legal problems

IV) Use that causes interpersonal/social problems

Substance Intoxication

Criteria

I) Reversable substance specific syndrome

II) Maladaptive behavior because of substance

III) Sxs not due to a medical condition

Substance Withdrawal

Criteria

I) Syndrome due to cessation of use

II) Syndrome interferes with life

III) Syndrome not due ot a medical condition

Substance Induced Disorders

Alcohol Induced w/ Specifiers

I) Psychotic disorder

II) Mood disorder

III) Anxiety disorder

IV) Sexual dysfunction

V) Sleep disorder

*with onset during intoxication

*with onset during withdrawal

Conversion Disorder

Criteria

I) Sensory or motor deficits suggesting neurological or other medical condition

II) Psychological stressors precede medical/physical symptoms

III) Not faked

IV) Can't be explained medically

VI) impairment

VII) physical medical symptoms not limited to pain or sexual dysfuncton

Conversion Disorder

Specifiers

A) with motor symptom or deficit

B) with sensory symptom or deficit

C) with seizuresor convulsions

D) with mixed presentations

Pain Disorder

Criteria

I) Pain somewhere

II) Impairment

III) Psychological factors involved in pain

IV) Not faked

V) Not other disorder

Note: Only codable as a pain disorder associated with psych factors or pain disorder associated with psych factors & gen. medical cond.

Pain Disorder

Specifiers

A) Acute - less than six months

B) Chronic - 6 months or more

Hypochondriasis

Criteria & Specifier

I) Fear of having a disease

II) Fear exists despite medical evidence to the contrary

III) Not delusional

IV) Impairment

V) Duration of 6 or more months

VI) Not medical

Specifier:

With poor insight 

Body Dysmorphic Disorder

Criteria

I) Preoccupied with perceived deficit in appearence

II) Impairment

III) No other mental disorder

Factitious Disorder

Criteria & Specifiers

I) Faking it

II) Sick role

III) External incentives

Specifiers:

A) with predominantly psyhological signs and symptoms

B) with Physical Sxs

C) with combined psych. and physical Sxs

D) NOS

Dissociative Amnesia

Criteria

I) Can't recall personal info. (usu traumatic)

II) Disturbance not limited to other condition (dissociative disorder, somatization disorder, etc.)

III) Impairment

Dissociative Fugue

Criteria

I) Sudden unexpected travel and inability to recall one's past

II) Identity disorder

III) not exclusively in disocciative identity disorder or due to substance

IV) Impairment 

Dissociative Identity Disorder

Criteria

I) 2+ personalities

II) these personalities will take control

III) inability to recall

IV) not due to substance or medical

Depersonalization Disorder

Criteria

I) Out of body experience (observing)

II) Reality testing intact

III) Impairment

IV) Not exclusively during other disorder

Sexual Dysfunctions

Hypoactive Sexual Desire Disorder

Criteria

I) Lack of sexual fantasies or desire

II) Distress or interpersonal difficulty

III) Not other cause

Sexual Aversion Disorder

Criteria

I) Doesn't want to engage in sexual activity with partner

II) Distress or interpersonal difficulty

III) Not other cause

Female Sexual Arousal Disorder

Criteria

I) Can't achieve sexual excitement

II) Distress or interpersonal difficulty

III) Not other cause

Male Erectile Disorder

I) Can't get or maintain an erection

II) Distress or interpersonal difficulty

III) Not other cause

Female or Male Orgasmic Disorder

Criteria

I) Trouble having an orgasm

II) Distress or interperosnal difficulty

III) Not other cause

Premature Ejaculation

Criteria

I) I) Ejaculation before desired

II) Distress or interpersonal difficulty

III) Not other cause

Dyspaneuria (intercourse painful)

Criteria

I) Intercourse painful

II) Distress or interpersonal difficulty

III) Not other cause

Vaginismus

Criteria

I) Spasm in the vagina that interferes with intercourse

II) Distress or interpersonal difficulty

III) Not other cause

Subtypes of Prmary Sexual Dysfunctions

Lifelong Type: Present since puberty

Aquired Type: After a period of normal functioning

Generalized Type: Not limited to certain situations

Situational Type: Limited to certain situations

Due to psychological factors

Due to combined factors: 1) Psychological +

                                    2) medical/substance

Substance Induced Sexual Dysfunction

Criteria

I) Significant sexual dysfunction

II) Fully explained by substance abuse

a- within a monthof intoxication

b- medication use causes

c- not other cause 

Substance Induced Sexual Dysfunction

Specifiers

a) with impaired desire

b) with impaired arousal

c) with impaired orgasm

d) with sexual pain

e) with onset during intoxication

Exhibitionism

Criteria

I) 6+ months of desire to show gentials to others

II) person has acted on desire or has marked stress/interpersonal problems due to desire

Fetishism

Criteria

I) 6+ months of sexual desire/fantasy about non-living objects

II) Interferes with functioning

III) Not limited to female clothing in cross dressing or sex devices

Frotteurism

Criteria

I) 6+ months of sexual desire to rub up against someone

II) Person has acted on urges or they cause distress

Pedophillia

Criteria

I) 6+ months of sexual desire towards children

II) Person has acted on urges

III) Person is at least 16 and 5 years older than child

Pedophillia

Specifiers

a) sexually attracted to males

b) sexually attracted to females

c) sexually attracted to both

d) limited to incest

e) Exclusibe type (only attracted to children)

f) Non-exclusive type

Sexual Masochism

Criteria

I) 6+ months of sexual desire involving being hurt in some way

II) desires cause stress or impairment

Sexual Sadism

Criteria

I) 6+ months of sexual desire involving hurting someone else

II) desires cause distress or impairment or have been acted upon a non-concenting person

Transvestic Fetishism

Criteria & Specifier

I) 6+ months of sexual desire involving cross dressing

II) desires cause distress or impairment

Specifiers:

a) with gender dysphoria (discomfort with gender role)

Voyeurism

Criteria

I) 6+ months of sexual desire involving watching others who are naked or having sex without them knowing

II) desires cause distress or impairment or has acted on the urges

Gender Identity Disorder

Criteria for Children

A) A persistent cross gender identification

In children must have 4 (or more):

I) desires to or insists that one is the other sex

II) desire to wear clothing go the the other sex

III) preferes cross role in play

IV) wants to participate in pass times of the other sex

V) wants playmates of the other sex

B) Discomfort with his/her own sex or sense of inappropriateness of gender role

C) Not due to being a hermaphrodite or the like

D) Causes distress or impairment

Gender Identity Disorder

Criteria for Adults

A) A persistent cross gender identfication

I) Desire to be the other sex

II) Passing as the other sex

III) Want to be treated as the other sex

IV) Convinced has feelings and rxns of other sex

B) Discomfort with his/her own sex or sense of inappropriateness of gender role

C) Not due to being a hermaphrodite or the like

D) Causes distress or impairment

Gender Identity Disorder

Coding & Specifiers

Coding:

- Gender Identity Disorder in Children

- Gender Identity Disorder in Adolescents or Adults

- Gender Identity Disorder NOS

Specifiers:

- Sexually attracted to males

- Sexually attracted to females

- Sexually attracted to both

- Sexually attracted to neither 

Substance Related Disorders

Differentials

A) Substance Intoxication Delirium

B) Substance Induced Psychotic D/O w/onset during intoxication

C) Substance Induced Mood D/O w/onset during intoxication

D) Substance Induced Anxiety D/O w/onset during intoxication

E) Substance Induced Sleep D/O w/onset during intoxication

F) Substance Induced Sexual Dysfunction w/onset during intoxication

Substance Related Disorders

Differentials

A) General medical conditions

B) Sedative, Hypnotic, or Anxiolytic Intoxication

C) Sedative, Hypnotic, or Anxiolytic Withdrawal

Substance-Related Disorders

Differentials

A) Primary mental disorders (Schizophreniform, Schizophrenia)

B) Cocaine, Hallucinogen, and Phencyclidine Intoxicaton

C) Cocaine, Hallucinogen, and Phencyclidine Dependence

D) Other Amphetamine-Induced Disorders

Anorexia Nervosa

Differentials

A) General medical conditions

B) Superior mesenteric artery syndrome

C) Major Depressive Disorder

D) Social Phobia

E) Obsessive-Compulsive Disorder

F) Body Dysmorphic Disorder

The subtypes of Anorexia Nervosa are...

A) Restricting type

B) Binge-Eating/Purging Type

The subtypes of Bulimia Nervosa are...

A) Purging Type

B) Non-Purging Type